Barium Swallow Test - An Overview

Introduction:

A barium swallow test, a cine esophagram, swallowing study, esophagography, modified barium swallow study, or videofluoroscopy swallow study, is a very advanced form of image test in which it produces pictures of your upper gastrointestinal tract using the compound of barium and X-rays. The upper GI tract includes the back of your mouth and throat, the esophagus, and the pharynx.

What Is the Barium Swallow Test?

Barium sulfate is a dry, white, chalky powder mixed with water to make a barium solution. Barium is an X-ray absorber and looks white on X-ray film. The barium swallow test allows viewing the size and shape of the pharynx and esophagus and the way of swallowing. Barium is used only for diagnostic studies of the gastrointestinal tract. Barium makes certain body sections stand out more in an X-ray during a swallowing test. This way, the radiologist can see the size and shape of the esophagus and pharynx. He or she will also be able to understand how you are swallowing. Details like these may not be evident from a standard X-ray. Barium is used solely for imaging tests for the GI tract. When swallowed, barium coats the lining of the upper gastrointestinal tract. Barium is used to create clear images on an X-ray during a swallowing test. It provides better contrast images. The use of barium sulfate contrast is more sensitive than that of water-soluble agents such as Gastrografin or Diatrizoate.

• Modified Barium Test: A modified barium swallow is a test to see what happens when people swallow various foods or liquids. This test uses a special type of X-ray known as fluoroscopy, a real-time X-ray form to help analyze swallowing.

• Barium Swallow versus Barium Enema: In barium swallow or barium meal, the barium sulfate powder is mixed with water and then swallowed. X-rays are taken when swallowing the mixture. In barium enema, the powder is mixed with water and inserted into the rectum through a tube into the large intestine, and X-rays are taken.

Why Is a Barium Swallow Test Done?

A barium swallow test is done to diagnose problems of the pharynx and esophagus, including:

• Cancer of the pharynx, or esophagus, neck, and head.

• Structural abnormalities such as diverticulum, narrowing of the esophagus, or any polyps.

• Hiatal hernia (where a part of the stomach pushes into the diaphragm).

• Muscle disorders like difficulty swallowing or spasms.

• Gastrointestinal reflux disease and ulcers.

• Enlarged veins in the esophagus.

It is used to diagnose the cause of some symptoms, like:

• Trouble swallowing.

• Abdominal pain.

• Bloating.

• Vomiting.

How to Prepare for a Barium Swallow Test?

The patient is advised to stop eating or drinking anything eight hours before the procedure.

• Inform the doctor whether you are pregnant or about to get pregnant before undertaking a barium swallow test.

• Before a swallow test, inform the doctor if you are sensitive or allergic to any medicine or anesthesia.

• Inform the doctor about your medications, such as vitamin and herbal supplements.

• Inform us if you have had a recent barium swallow or an upper gastrointestinal series test.

What Happens During the Barium Swallow Procedure?

A radiologist usually performs a barium swallow test. The patient is asked to remove any eyewear, jewelry, or any type of other thing interfering with the procedure. The patient wears a surgical gown during the procedure. The patient is asked to lie on a table. A barium swallow is an outpatient procedure and does not require sedation or anesthesia. The radiologist first takes standard X-rays of the chest and abdomen. Then, the patient is asked to swallow a thick, chalky barium solution. Barium is usually flavored, but it does not taste good.

As the patient swallows barium, the radiologist takes a series of X-rays to watch the barium move through the mouth and throat. Next, a thinner barium solution is given to swallow, and again, X-rays are taken as the barium moves down the esophagus. The patient is asked to change positions and sometimes hold their breath during the procedure. The patient may also be asked to swallow a barium pill, which can highlight problems in the esophagus. The barium swallow procedure takes about 30 minutes.

Patients can continue their diet and activities after the barium swallow test. However, barium can cause constipation if not eliminated from the body. The patient is advised to drink plenty of fluids and eat a high-fiber diet to improve constipation symptoms and help remove the remaining barium from the body. The bowel movements can be white or mild in color until all the barium is eliminated.

What Are the Risks of a Barium Swallow Test?

The risks of a barium swallow test include problems from radiation exposure, intestinal issues, and birth defects. Pregnant women should not undergo a barium swallow test as it may lead to birth defects. A small amount of barium can go into the airway while drinking barium.

Some side effects of barium swallow include:

• Most people complain of nausea or vomiting within 30 minutes of ingestion.

• The trouble with bowel movements or being unable to have a bowel movement or pass gas.

• Swelling of the abdomen or any type of pain.

• Fever.

• Smaller stools than normal.

Contraindications:

Avoid a barium swallow test in the following conditions:

• Perforation in the esophagus or intestine.

• Blockage in the intestine.

• Severe constipation.

• Problems with swallowing.

• Allergy or sensitivity to medicines, anesthesia, iodine, and contrast dyes.

How Are Results Evaluated?

The result can be positive or negative.

• Negative Result: There are no abnormalities in the size, shape, and movement of the throat, esophagus, stomach, and first part of the small intestine.

• Positive Result: Some abnormalities or conditions are present if the result is positive. If the result is positive, the doctor recommends an endoscopy procedure. A, flexible thin tube attached to a camera on one side is inserted into the mouth and the esophagus. During endoscopy, a tissue sample (biopsy) is also collected for examination in the laboratory.

Conclusion:

Barium swallows are a useful diagnostic tool for checking upper gastrointestinal tract problems. It is a less invasive procedure than endoscopy. It is generally a safe test with fewer complications. Barium goes through the digestive system and does not cause any harm. Your body may retain barium following the swallow test for constipation or impacted stool. Management of constipation can be done by drinking lots of fluids and fiber-rich foods to allow the rest of the barium to exit your system. You can also receive a prescription for a laxative.